Gastrinomas are the most common symptomatic, malignant pancreatic neuroendocrine tumor (pNET) in patients with or without MEN1 and sufficient numbers of these patients have been entered into our protocols to allow systematic assessment. A number of different studies were completed this year including one dealt with the success of reoperation in 52 ZES patients after an initial non-curative surgery. After reoperation 18/52 patients were initially disease-free (35%) and after a mean follow-up of 8yrs, 13/52 remained disease-free (25%). This result suggesting all ZES patients post-resection should have systematic imaging, and if tumor recurs, advise repeat operation. During this year information from our prospective studies was used to write a number of guideline and position papers dealing with the diagnosis of these tumors and other NETs, treatment of advanced disease and pharmacological approach to management.